Which finding supports ATFL injury on the anterior drawer test?

Which finding supports ATFL injury on the anterior drawer test?

• A. Excessive anterior translation
• B. Excessive posterior translation
• C. Pain with eversion
• D. No laxity

Answer: (A)

The anterior drawer test specifically checks how much the talus can move forward under the tibia, which is resisted by the ATFL. If the ATFL is injured, it can no longer restrain that forward movement, so there is excessive anterior translation of the talus when the foot is in plantarflexion and the talus is drawn forward. That increased forward movement is the clearest sign of ATFL damage. Excessive posterior translation would point to instability of structures that resist backward movement, not ATFL. Pain with eversion suggests issues with the lateral or medial ligaments depending on the test, but isn’t the hallmark of ATFL injury on this specific test. No laxity would imply the ligaments are intact.

The anterior drawer test specifically checks how much the talus can move forward under the tibia, which is resisted by the ATFL. If the ATFL is injured, it can no longer restrain that forward movement, so there is excessive anterior translation of the talus when the foot is in plantarflexion and the talus is drawn forward. That increased forward movement is the clearest sign of ATFL damage.

Excessive posterior translation would point to instability of structures that resist backward movement, not ATFL. Pain with eversion suggests issues with the lateral or medial ligaments depending on the test, but isn’t the hallmark of ATFL injury on this specific test. No laxity would imply the ligaments are intact.